The House of Representatives and Provincial election is schedule to be held in November 26 and 7 December. The voters of 32 districts mainly from the hilly and mountain region of the country will be voting on the first phase. It will be held in 37 electoral constituencies for the federal parliament and 72 seats for provincial assembly. The second phase of elections will be held in 128 electoral constituencies for parliamentary election and 256 seats for provincial assembly.

This is the first parliamentary election after the constitution was promulgated formally turning country as a federal republic. The election will effectively bring three layers of government—local, provincial and federal into existence and the seven provinces will come into operation.Different political parties have released their election manifestos prior to the upcoming election. These manifestos reveal the plan of the party’s vision towards the development of the nation. The election manifestos generally specify the commitments, policies and programmes of a political party. These manifestos help the reader to understand the party and help them to choose the right fit.

As a national development organization with health and nutrition as its priority sector, HERD team sought to collect and synthesise the prioritisation made by political parties in health and nutrition sector, through the election manifestos. In this study we examined the election manifestos of political parties namely Nepali Congress, Left Alliance (alliance of Communist Party of Nepal – Unified Marxist Leninist and Maoists Centre), Rastriya Prajatantra Party (RPP), Bibeksheel Sajha Party and Naya Shakti Nepal to understand their commitment in the health sector. Since manifestos of other parties were not available online, Manifestos of these five parties have only been included in this study.

The health related election manifestos of 5 major political parties are as follows;

  • Left Alliance The implementation of fundamental rights concerning health will be guaranteed. All the citizens will be included in government’s health insurance programme. The government will waive 50% of the cost that has to be paid for the insurance to those under the poverty line. Free treatment will be provided to the children under 15 years of age and elderly above 65 years of age.
  • Hospital with capacity of 25 beds will be brought into operation in every rural municipality and 50 beds in every municipality. Health post and round the clock service including mobile health service with necessary human resource, medicine, equipment’s, technology and health works will be brought into operation.
  • Allopathic, ayurveda, homeopathic, yunani, acupuncture, amchi and other natural and traditional health services as well as alternative treatment process will be introduced and brought forth in a united and coordinated manner. The herbs and medicine products found in Nepal will be protected and improved for production.
  • Child mortality will be reduced by ensuring adequate availability of immunisation, health services and nutritious food as well as suitable care for children.
  • Medicines, blood testing and check-ups for fatal diseases like high blood pressure, diabetes, kidney diseases, asthma, cancer etc. will be provided free of cost. Dialysis and transplant services for kidney patients will be made free of cost. Effective prevention and control of mental health problems and diseases such as dengue, chikungunya, malaria, kalazar, encephalitis, TB, pneumonia, typhoid, diarrhoea and sickle cell will be done.
  • Well-equipped 100 bed hospital will be established in every province headquarter. A well-equipped diagnostic centre with required resources will be built near the hospital. Similarly, trauma centre, operation theatre, ICU centre and ventilator centre will be established. Recent technologies will be installed in all these centres. Long wait for receiving the health treatment will come to an end.
  • The current salary of the health workers and doctors working at the government hospital will be increased by 200 per cent. Allowance will be arranged and facility of overtime allowance will also be made. The decision of doctors, nurse and health workers working at the government hospital not being allowed to work in the private sector will be implemented strictly.
  • Production and distribution of tobacco and alcohol products will be strictly regulated.
  • Toilet and smoke free kitchen will be arranged in every household. Criteria will be determined for proper management of smoke, dust and chemicals.
  • Programmes related to adolescent sexual and reproductive health will be brought into operation. Exercise, yoga and entertainment will be made integral part of the people’s lifestyle. Handicapped people will be provided with free health services at the local hospital.
  • The facility of air ambulance will be introduced in marginalized villages. Free treatment will be provided for the victims of sudden accidents and natural disasters.
  • Research and investigations related to health will be encouraged. The practice of using health education as a medium for earning profit will be discouraged.

Nepali Congress

  • Management of arsenic free drinking water in the Terai region.
  • To end the malnutrition and hunger, NC is determined to reduce the number of poor population among the total population to less than 3 per cent within ten years.
  • The "Integrated Social Security" package will be brought to the table by incorporating post-natal mother and child nutrition, assurance of quality education, youth’s skill building, unemployment allowance and senior citizen service.
  • Health check-up and basic treatment will be managed every month in all schools and nursing services and facilities will be provided in a more permanent way in all the schools.
  • With the aim of “trustworthy, quality and accessible health services to all”, NC will implement the health policies and programme.
  • The aim of the health policy will be: “there will be no early death due to lack of treatment facility of treatable diseases”. Fifteen bedded hospitals along with the facility of birthing centre will be constructed in every rural municipality. In every municipality, as per the necessity, 25 to 50 bedded modern hospital will be constructed. These hospitals will be affiliated with the large city area, state and central level hospital service.
  • NC is determined to reduce the child mortality rate to less than 15 and maternal mortality (among 100000 living births) to less than 50 in coming ten years. Health policy and structure will be prepared to prevent deaths from waterborne diseases including malaria, kalazar, dengue and hepatitis.
  • Social service unit will be made in all the government hospitals. The program which has been providing support to the treatment of twelve major diseases will be implemented for other additional diseases as well. Free dialysis services will be expanded to local level while the free arthritis, heart disease and kidney transplant service will be made feasible. Cervical cancer examination will be expanded to local level.
  • The scheme of sending doctors (who have studied medicine in scholarship or through other support) to the hospitals in rural municipality, will be made more attractive and effective.
  • The health insurance of every Nepali citizen will be ensured.
  • Non-governmental sectors will be operated as service providers.
  • Special program will be developed for the promotion of indigenous ayurveda industry, expansion of treatment centres, promotion of ayurveda knowledge, production of skilled ayurveda practitioners and experts.
  • Existing and to be opened hospitals will be made capable to deliver medical services of international standard and support will be provided to make Nepal a place for special medical treatments. The quality standards for private hospital and clinics will be set and implemented.
  • Programs for ensuring toilet construction in each house will be brought forward.
  • Families of poor category will be provided with grant for toilet construction. Safe drinking water will be distributed to all the residential areas within 5 years.
  • The Sanitation programs will be directed towards the conservation of water reservoirs and maintaining quality of drinking water.
  • With the slogan “Lactating Mother: Nutritious Food”, nutrition coupon will be distributed to women delivering from local health facility up to two years. Similarly, regular incentive will be managed for nutrition of pregnant women. Free neonatal treatment program will be scaled up throughout the district.
  • The incentive and facilities provided to FCHVs will be made double within two years.
  • Maternal, neonatal and child health programmes will be made accessible to every people. For this, the ongoing golden thousand days’ programme will be scaled up to all the wards.
  • The maternal incentive given to the women delivering in government hospital will be doubled.
  • To control and end the violence, exploitation, discrimination and exclusion against women for which easily accessible law enforcement will be managed.
  • The legal system will be made easily accessible to reach to prevent and control all kind of violence, exploitation, discrimination, depression and exclusion.
  • A female police team will be operated within the police system to control and demotivate violence and bad behaviour with women in public places.

RPP

  • A National body of authority will be formed to manage issues like services, facilities and fees of nursing homes and private hospitals.
  • One hospital similar to Kathmandu’s Bir hospital, will be established in all seven provinces.
  • With the aim of having no death due to lack of treatment of cancer, kidney and heart diseases, mechanism of free treatment of such diseases will be developed.
  • Development, modification and expansion of ayurvedic and ancient medicine system.
  • Mechanism of providing monthly incentives of at least 2000 to FCHVs will be developed.
  • One hospital of at least 25 beds will be constructed in each rural municipality/ municipality.
  • For management of basic health service and expansion of health related awareness in a door to door approach, two FCHVs in each ward of rural municipality/ municipality will be appointed and provided with necessary trainings.
  • Health insurance of every citizen of the rural municipality/municipality will be ensured.
  • Nutritional grant of 5000 rupees per baby will be provided by rural municipality/municipality through the postnatal mother to babies born in poor family.
  • Bibeksheel Sajha Party With the belief that basic services like education, health, public transport is the state’s main responsibility, Bibeksheel Sajha Party will ensure accessible and quality education and health services by restoring the role of non-governmental sector.
  • Gradually, the system of drinking water in all rural municipality and municipality will be constructed.
  • To ensure accessible and quality health services across the country, review of laws and policies of different sectors like medical education, hospital management and service, health insurance, pharmaceutical industry and business will be done and necessary improvements will be made.

Naya Shakti

  • Health insurance program will cover all citizens within 5 years.
  • Free health service will be managed to children under 15 years and elder people above 65 years.
  • 75 per cent discount in health services will be arranged for people with complete physical disability, pregnant women, single women, war survivors, Dalit community, sexual and gender minority group and families under the poverty line.
  • Taking into account the fact that people in Karnali and other remote areas are dying because of timely access to hospital. Five helicopters will be arranged for transportation of women and patients who are in need of emergency treatment.
  • Pregnant women will be provided with free nursing and postnatal service.
  • Arrangements will be made for providing nutrition allowance to women of agricultural labour sector during postnatal period.
  • Similarly, free treatment will be provided to women for specific diseases such as uterus and breast cancer, uterine prolapse and obstetric fistula.
  • Maternal leave to working women will be made 3 months for up to two children. Newborn care centres will be expanded. Allowance being provided to single women will be increased.
  • Proper arrangement for nutritious food, education, health and entertainment to all children will be made.
  • Two hospitals of 500 beds each will be established in each province.
  • Fast track women justice will be established to end women violence.
  • Mechanism of tough punishment to the accused and compensation to the violence survivor by the state itself will be developed. For the rescue and rehabilitation of women suffering from violence, one Psychological Counselling Centre with residential facility will be established in each district.

DISCUSSIONS

All the above mentioned parties have committed for the betterment of the health sector and have stated health as one of their top priority. All the parties have expressed their high level of commitments to provide quality and affordable health services to all the citizens of Nepal, covering all the village municipalities and municipalities. Establishing a well-equipped health facility in every province is also in the priority of political parties as reflected in their manifestos. Similarly, health insurance scheme, child health and reproductive health have also been stressed. Besides those, certain communicable and non-communicable diseases are also specifically addressed in the political menifestos,

UML MC in its manifesto has said that health post and round the clock service including mobile health service with necessary human resource, medicine, equipment’s, technology and health works will be brought into operation. It has further focused that the current salary of the health workers and doctors working at the government hospital will be increased by 200%. Allowance will be arranged and facility of overtime allowance will also be made. It has also been determined to implement the decision of doctors, nurse and health workers working at the government hospital will not being allowed to work in the private sector. Programmes related to adolescent sexual and reproductive health will be brought into operation. To make the health services accessible UML MC has focused on introducing facility of air ambulance for marginalized villages.

Nepali Congress is determined to reduce the number of poor population among the total population to less than 3% within ten years so as to end the malnutrition and hunger. It has committed to bring the "Integrated Social Security" package to the table by incorporating postnatal mother and child’s nutrition, assurance of quality education, youth’s skill building, unemployment allowance and senior citizen service. NC has also stressed that the scheme of sending doctors (who have studied medicine in scholarship or through other support) to the hospitals in rural municipality, will be made more attractive and effective.

RPP has committed to form a national body of authority to manage issues like services, facilities and fees of nursing homes private hospitals. It has focused on developing mechanism of providing monthly incentives of at least 2000 to FCHVs. For management of basic health service and expansion of health related awareness in a door to door approach, it has agreed to appoint and provide training to two FCHVs in each ward of rural municipality/ municipality. It has also committed to provide nutritional grant of 5000 rupees per baby by rural municipality/municipality through the postnatal mother to babies born in poor family.

Bibeksheel Sajha Party in its manifesto mentioned that basic services like health among others services is the state’s main responsibility. The party has committed ensuring accessible and quality education and health services by restoring the role of non-governmental sector. In order to ensure accessible and quality health services across the country, they have further committed to review of laws and policies of different sectors like medical education, hospital management and service, health insurance, pharmaceutical industry and business and make necessary improvements.

Considering the fact that people in Karnali and other remote areas are dying because they can’t access to hospital on time, Naya Shakti Nepal has committed to arrange five helicopters for transportation of women and patients who are in need of emergency treatment. It has also focused on providing nutrition allowance to women of agricultural labour sector during postnatal period. The party has said that maternal leave to working women will be made 3 months for up to two children. Newborn care centers will be expanded and allowance being provided to single women will be increased.

Although mentioned in separate papers, the vision of all the parties is the betterment of health sector of Nepal and access to health service for every citizen. Manifestos are the outline of the party’s vision and are  developed with ambitious vision and aims. The manifestos are often impressive but there is no guarantee that all the mentioned points will be addressed. The manifestos are created based on the current scenario and need of the nation. It is not just words but a long term commitment made to the people who have a lot of faith in the party.

CONCLUSION

The manifesto is a very important document which shows what the parties plan to do if they win the election. These documents help the eligible voters to know who is competing in the election and what plans, agendas and commitments they have for the development of the nation. It is an important part of the election where the voters learn about the party and choose their leader. The commitments made in the manifesto has a very big say in the publics voting decision.

We have observed that all the parties have the similar priority mainly focusing on the improvement of health status of the citizens by ensuring rights of the public. All the parties have presented diverse plans and activities for the health sector to achieve their goal. Some of the commitments are very ambitious and will demand large number of human resources and increased government funding for its implementation. These manifesto provides a basis on which the public can later judge the success and make elective representative more accountable on their commitments.

Based on the previous experience, not all the political commitments have been fulfilled. Therefore, there is increasing pressure to the winning party and elected representative to fulfil their commitments and satisfy public expectations. So, if the parties fulfil their commitments as stated, it will be very beneficial for well-being of the citizen and overall development of the health sector..

Contributors: Kritagya Regmi and Aanchal Parajuli